Students participating in programs with which the VA Medical Center has a current affiliation agreement will be permitted learning opportunities. Consult your school, course coordinator or instructor for affiliation details.

Procedure

• Step 1: Contact instructor from affiliated institution to determine clinical training opportunities.
  
• Step 2: Read orientation materials
  • "Orientation Handbook"
  • Rules of Behavior (Confidentiality/Privacy and Computer Access Agreement)
    
• Step 3: Submit the following to your instructor (contact your instructor for submission deadlines):
  
  • Signed "Acknowledgement of Orientation" located in the "Orientation Handbook" (acknowledgement only!)
  • Signed "Rules of Behavior" (Confidentiality/Privacy and Computer Access Agreement) located in the "Orientation Handbook"
  • Signed "Statement of Commitment"
  • Completed Application for Nurses and Nurse Anesthetists - VA Form 10-2850-A
  • Completed Application for Associated Health Occupations - VA Form 10-2850-C
  • Completed Declaration for Employment OF-306
  • Completed Clinical Trainee Registration Form VA Form 10-0410
  • Signed Without Compensation (WOC) Appointment Letter
  • Request for Personal Identity Verification (PIV) PIV Form. VA Form 0711 (Section 1 only) *
  • Selective Service Registration
    If you are a male born after December 31, 1959 and are at least 18 years of age, you MUST be registered with the Selective Service System. On your start date you will need to certify that you have registered. If you are not currently registered, complete registration at http://www.sss.gov/ 
  • Security Check:*
    • Special Agreement Check (SAC) Form (Fingerprint Application)
    • In addition to the SAC, complete OPM Form 85 (EG) Questionnaire for Non-Sensitive Positions (PDF) NACI - National Agency Check with Written Inquiries (NACI) - if facility assignment is greater than 6 months.

    *valid IDs required during fingerprinting process: 

    • U. S. Passport OR Federal or state-issued photo identification (driver's license or school ID card with photograph)
      AND
    • birth certificate OR social security card

    Proof of naturalization will be required for all non-U.S. citizens (if applicable)
    

• Step 4: Report to Discipline Specific Coordinator as directed by instructor to obtain VA ID badge and fingerprinting
  
• Step 5: Upon completion of clinical training:
  • Complete student evaluations:
    • Local hardcopy evaluation Clinical Training Evaluation
    • National online evaluation: VA Learners' Perceptions Survey
  • Return VA ID badge to instructor